title: Gastroesophageal reflux in children with functional constipation.
abstract: OBJECTIVE
  Functional constipation and gastroesophageal reflux disease are two major and commonly encountered components of childhood functional gastrointestinal disorders. Epidemiological studies in the adult population support that there is a significant overlap between the different functional disorders of the digestive tract. Therefore, we aimed to investigate the frequency of gastroesophageal reflux disease in children with functional constipation and to compare clinical findings and 24-h esophageal pH monitoring with a group of patients with suspected gastroesophageal reflux disease.
  
  
  METHODS
  Children between 4 and 16 years old with functional constipation (based on Rome III criteria, Group 1; n=38) were prospectively evaluated. A control group was composed of patients with symptoms suggesting gastroesophageal reflux disease (Group 2; n= 40). All patients included in the study were asked about reflux-related symptoms, and then all cases underwent 24-h esophageal pH monitoring analysis.
  
  
  RESULTS
  Delayed gastric emptying symptoms such as belching and hiccups were more common in patients in Group 1 (p=0.002, p=0.021, respectively), whereas chronic cough was more common in patients in Group 2 (p=0.012). According to the 24-h esophageal pH monitoring, pathologic acid reflux in the lower and/or laryngopharyngeal portion of the esophagus was determined in 39.5% of the patients in Group 1 and in 42.5% of the patients in Group 2 (p=0.96). No significant difference was found in terms of age, gender and duration of constipation in patients with and without acid reflux in Group 1 patients. Pyrosis (66.6 vs. 0%, p=0.00001)was more common in Group 1 patients with acid reflux, but hiccups (20 vs. 69.5%, p=0.007) and belching (33.3 vs. 60.8%, p=0.184) were more common in patients in Group 1 without acid reflux.
  
  
  CONCLUSIONS
  Gastroesophageal reflux disease should be considered in the treatment and monitoring of patients with functional constipation. Further studies are needed using 24-h pH multichannel impedance.
authors.affiliation: Ege University Medical Faculty, Department of Pediatric Gastroenterology, Hepatology and Nutrition, İzmir, Turkey. baran19712002@yahoo.com
authors.forename: Maşallah
authors.initials: M
authors.lastname: Baran
authors.forename: Funda
authors.initials: F
authors.lastname: Özgenç
authors.forename: Çiğdem
authors.initials: Ç
authors.lastname: Arikan
authors.forename: Murat
authors.initials: M
authors.lastname: Çakir
authors.forename: Çiğdem Ömür
authors.initials: ÇÖ
authors.lastname: Ecevıt
authors.forename: Sema
authors.initials: S
authors.lastname: Aydoğdu
authors.forename: Raşit Vural
authors.initials: RV
authors.lastname: Yağci
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003248:Constipation / Q000453:epidemiology* / Q000503:physiopathology*; D017615:Enteric Nervous System / Q000503:physiopathology*; D004884:Eructation / Q000453:epidemiology / Q000503:physiopathology; D050782:Esophageal pH Monitoring; D005260:Female; D005744:Gastric Acid / Q000502:physiology; D005764:Gastroesophageal Reflux / Q000453:epidemiology* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D011446:Prospective Studies